Abstract W P183: Analysis of Infarct Patterns in the Stroke Patients with Patent Foramen Ovale
Background and Purpose: Patent foramen ovale (PFO), a persistence of the embryonic defect in the interatrial septum, is found in 25% of the general population. The role of patent foramen ovale (PFO) as a risk factor for stroke is still controversial. To find out the role of PFO in the stoke mechanism, we investigated the clinical and magnetic resonance imaging (MRI) findings in stroke patient with PFO.
Methods: Consecutive patients over 3 years, who were diagnosed with stroke and PFO at the Gachon University Gil Hospital, were analyzed. We divided into three groups, as follows: (1) highly associated with PFO (high-risk PFO, multiple acute ischemic lesions on diffusion-weighted image without the stenosis of relevant artery, n=46), less likely associated with PFO (low-risk PFO, acute ischemic lesions within the territory with the stenosis of supplying artery, n=35), undetermined associated with PFO (undetermined PFO, acute ischemic lesions in perforating artery territory without the stenosis of relevant artery, n=53). We compared the clinical, laboratory parameters, and MRI patterns among the three groups.
Results: Study population (n=134) had a mean age of 50.7±9.1. There was no statistically significant difference of prevalence of well-known risk factors such as hypertension, diabetes, hyperlipidemia, smoking, and previous history of stroke/coronary artery disease among the groups. RoPE score in high-risk PFO group was significantly higher than RoPE score in low-risk PFO group (Turkey’s post hoc test, p=0.047). Multiple regression analysis revealed that PFO associated with higher RoPE score is more possible cause of stroke (OR 1.57 per 1-point increase; 95% CI 1.09-2.27; p=0.016) and PFO with acute infarct in perforating artery territory is less likely cause of stroke (OR 0.067 perforating artery territory infarct (+); 95% CI 0.019-0.240; p<0.0001).
Conclusions: In 34.3% of the stroke patient with PFO, PFO seemed to play a important role in development of stroke. PFO may be the incidental findings when the lesions were found in deep perforating artery area without relevant artery stenosis and PFO combined with high RoPE score should be considered as cause of stroke.
Author Disclosures: D. Shin: None. D. Shin: None.
- © 2015 by American Heart Association, Inc.